The Effect of Pharmaceutical Benefits Managers: Is It Being Evaluated?

  1. Kevin A. Schulman, MD;
  2. L. Elizabeth Rubenstein, BA;
  3. Darrell R. Abernethy, MD, PhD;
  4. Damon M. Seils, BA; and
  5. Daniel P. Sulmasy, OFM, MD, PhD
  1. From the Georgetown University Medical Center, Washington, D.C. Requests for Reprints: Kevin A. Schulman, MD, Clinical Economics Research Unit, Georgetown University Medical Center, 2233 Wisconsin Avenue, NW, Suite 440, Washington, DC 20007. Current Author Addresses: Dr. Schulman, Ms. Rubenstein, and Mr. Seils: Clinical Economics Research Unit, Georgetown University Medical Center, 2233 Wisconsin Avenue, NW, Suite 440, Washington, DC 20007.

    Abstract

    Over the last decade, the number of pharmaceutical benefits managers has increased, and their influence has expanded rapidly. These managers now provide prescription drug coverage to more than 100 million Americans. The effect of pharmaceutical benefits managers on health care delivery remains unclear. We review the development of these organizations, their current role in the delivery of pharmaceutical therapies to patients, and their relationship with pharmaceutical manufacturers. We discuss potential advantages and disadvantages of pharmaceutical benefits manager practices and suggest ways in which these organizations can be made more accountable to the employer groups that hire them.

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